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1.
European Journal of Psychotraumatology ; 12(1), 2021.
Article in English | EuropePMC | ID: covidwho-1565028

ABSTRACT

Background and Objectives Prevalent Post-traumatic Stress Disorder (PTSD) negatively affected individuals during the COVID-19 pandemic. Using network analyses, this study explored the construct of PTSD symptoms during the COVID-19 pandemic in China to identify similarities and differences in PTSD symptom network connectivity between the general Chinese population and individuals reporting PTSD. Methods We conducted an online survey recruiting 2858 Chinese adults. PTSD symptoms were measured using the PCL-5 and PTSD was determined according to the DSM-5 criteria. Results In the general population, self-destructive/reckless behaviours were on average the most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) avoidance of thoughts and avoidance of reminders, 2) concentration difficulties and sleep disturbance, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviours, and 5) hypervigilance and exaggerated startle responses. Besides, negative connections were found between intrusive thoughts and trauma-related amnesia and between intrusive thoughts and self-destructive/reckless behaviours. Among individuals reporting PTSD, symptoms such as flashbacks and self-destructive/reckless behaviours were on average most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) concentration difficulty and sleep disturbance, 2) intrusive thoughts and emotional cue reactivity, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviour, and 5) detachment and restricted affect. In addition, a negative connection was found between intrusive thoughts and self-destructive/reckless behaviours. Conclusion Our results indicate similarly positive connections between concentration difficulty and sleep disturbance, negative beliefs and negative trauma-related emotions, and irritability/anger and self-destructive/reckless behaviours in the general and PTSD-reported populations. We argue that self-destructive/reckless behaviours are a core symptom of COVID-19 related PTSD, worthy of more attention in future psychiatric programmers. HIGHLIGHTS The most central symptom for the general group was self-destructive/reckless behaviours and for the PTSD subgroup was flashbacks. Results matched the hybrid model of PTSD and were important for prevention and intervention for PTSD related to COVID-19.

2.
Eur J Psychotraumatol ; 12(1): 1997181, 2021.
Article in English | MEDLINE | ID: covidwho-1559184

ABSTRACT

Background and Objectives: Prevalent Post-traumatic Stress Disorder (PTSD) negatively affected individuals during the COVID-19 pandemic. Using network analyses, this study explored the construct of PTSD symptoms during the COVID-19 pandemic in China to identify similarities and differences in PTSD symptom network connectivity between the general Chinese population and individuals reporting PTSD. Methods: We conducted an online survey recruiting 2858 Chinese adults. PTSD symptoms were measured using the PCL-5 and PTSD was determined according to the DSM-5 criteria. Results: In the general population, self-destructive/reckless behaviours were on average the most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) avoidance of thoughts and avoidance of reminders, 2) concentration difficulties and sleep disturbance, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviours, and 5) hypervigilance and exaggerated startle responses. Besides, negative connections were found between intrusive thoughts and trauma-related amnesia and between intrusive thoughts and self-destructive/reckless behaviours. Among individuals reporting PTSD, symptoms such as flashbacks and self-destructive/reckless behaviours were on average most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) concentration difficulty and sleep disturbance, 2) intrusive thoughts and emotional cue reactivity, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviour, and 5) detachment and restricted affect. In addition, a negative connection was found between intrusive thoughts and self-destructive/reckless behaviours. Conclusion: Our results indicate similarly positive connections between concentration difficulty and sleep disturbance, negative beliefs and negative trauma-related emotions, and irritability/anger and self-destructive/reckless behaviours in the general and PTSD-reported populations. We argue that self-destructive/reckless behaviours are a core symptom of COVID-19 related PTSD, worthy of more attention in future psychiatric programmers.


Antecedentes y Objetivos: El Trastorno de Estrés Postraumático (TEPT) prevalente afectó negativamente a los individuos durante la pandemia del COVID-19. Usando análisis de redes, este estudio exploró el constructo de síntomas de TEPT durante la pandemia de COVID-19 en China para identificar las similitudes y diferencias en la conectividad de red de síntomas de TEPT entre la población general china y los individuos que reportan TEPT.Métodos: Realizamos una encuesta en línea que reclutó 2.858 adultos chinos. Los síntomas de TEPT se midieron usando el PCL-5 y el TEPT se determinó de acuerdo a los criterios del DSM-5.Resultados: En la población general, las conductas autodestructivas/ imprudentes fueron, en promedio, las más fuertemente conectadas con otros síntomas de TEPT en la red. Las cinco conexiones positivas más fuertes se encontraron entre 1) evitación de pensamientos y evitación de recordatorios, 2) dificultades en la concentración y trastornos del sueño, 3) creencias negativas y emociones negativas relacionadas con el trauma, 4) irritabilidad/ ira y conductas autodestructivas/ imprudentes y 5) hipervigilancia y respuestas de sobresalto exageradas. Además, se encontraron conexiones negativas entre pensamientos intrusivos y amnesia relacionada con el trauma y entre pensamientos intrusivos y conductas autodestructivas/ imprudentes. Entre los individuos que reportaron TEPT, los síntomas como flashbacks y conductas autodestructivas/ imprudentes estuvieron, en promedio, más fuertemente conectadas con otros síntomas de TEPT en la red. Las cinco conexiones positivas más fuertes se encontraron entre 1) dificultades en la concentración y trastornos del sueño, 2) pensamientos intrusivos y reactividad emocional a ciertas señales, 3) creencias negativas y emociones negativas relacionadas con el trauma, 4) irritabilidad/ ira y conductas autodestructivas/ imprudentes, y 5) desapego y afecto restringido. Además, se encontró una conexión negativa entre pensamientos intrusivos y conductas autodestructivas/ imprudentes.Conclusión: Nuestros resultados indican conexiones igualmente positivas entre dificultades en la concentración y trastornos del sueño, creencias negativas y emociones negativas relacionadas con el trauma, e irritabilidad/ ira y conductas autodestructivas/ imprudentes en la población general y la que reporto TEPT. Argumentamos que las conductas autodestructivas/imprudentes son un síntoma central de TEPT relacionado con COVID-19, que merece más atención en futuros programas psiquiátricos.


Subject(s)
COVID-19/psychology , Pandemics , Stress Disorders, Post-Traumatic/epidemiology , Adolescent , Adult , Aged , COVID-19/epidemiology , China/epidemiology , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Male , Middle Aged , Self-Injurious Behavior/psychology , Surveys and Questionnaires , Young Adult
3.
Preprint in English | EuropePMC | ID: ppcovidwho-296393

ABSTRACT

Fully effective vaccines for viruses such as Influenza and SARS-CoV-2 must elicit a diverse repertoire of antibodies against multiple drifted virus strains. However, how to achieve a diverse response has no general solution except to combine multiple strains, which risks diluting the response for all strains included. Here, we describe the synthesis of a universal, toll-like receptor 7 agonist (TLR7)-nanoparticle adjuvant, TLR7-NP, constructed from TLR7 agonist-initiated ring-opening polymerization of lactide and self-assembly with poly(ethylene glycol)- b -poly(lactic-co-glycolic acid). When mixed with Alum-adsorbed antigens, this TLR7-NP adjuvant elicited cross-reactive antibodies for both dominant and subdominant epitopes, as well as antigen-specific CD8 + T cell responses. TLR7-NPs adjuvanted influenza subunit vaccine successfully protected mice from heterologous viral challenge. TLR7-NPs also enhanced the antibody response to a SARS-CoV-2 subunit vaccine against multiple variants and revealed the mobilization of a virus-like response. We further demonstrate enhanced antigen-specific responses in human tonsil organoids with this novel adjuvant.

4.
Future Virol ; 0(0)2021 Oct.
Article in English | MEDLINE | ID: covidwho-1528784

ABSTRACT

Aim: To determine SARS-CoV-2 specific IgM and IgG levels of patients with COVID-19 at 8 months after symptom onset and to explore the predictors of antibody levels. Materials & methods: The magnetic chemiluminescence method was used to measure the antibody levels. Clinical data were collected and analyzed retrospectively. Results: A total of 54 patients were enrolled in this study, of whom 59.3% were IgM positive and 96.4% were IgG positive. The multiple linear regression analysis revealed that the duration of RNA shedding, C-reactive protein level and disease severity were independent predictors of IgG levels. Conclusion: COVID-19 patients retained long-term viral-specific protective immunity. Disease severity, C-reactive protein level and duration of RNA shedding were related to antibody levels 8 months after symptom onset.

5.
Front Med (Lausanne) ; 8: 696976, 2021.
Article in English | MEDLINE | ID: covidwho-1450816

ABSTRACT

Background: Previous research suggested that Chinese Medicine (CM) Formula Huashibaidu granule might shorten the disease course in coronavirus disease 2019 (COVID-19) patients. This research aimed to investigate the early treatment effect of Huashibaidu granule in well-managed patients with mild COVID-19. Methods: An unblinded cluster-randomized clinical trial was conducted at the Dongxihu FangCang hospital. Two cabins were randomly allocated to a CM or control group, with 204 mild COVID-19 participants in each cabin. All participants received conventional treatment over a 7 day period, while the ones in CM group were additionally given Huashibaidu granule 10 g twice daily. Participants were followed up to their clinical endpoint. The primary outcome was worsening symptoms before the clinical endpoint. The secondary outcomes were cure and discharge before the clinical endpoint and alleviation of composite symptoms after the 7 days of treatment. Results: All 408 participants were followed up to their clinical endpoint and included in statistical analysis. Baseline characteristics were comparable between the two groups (P > 0.05). The number of worsening patients in the CM group was 5 (2.5%), and that in the control group was 16 (7.8%) with a significant difference between groups (P = 0.014). Eight foreseeable mild adverse events occurred without statistical difference between groups (P = 0.151). Conclusion: Seven days of early treatment with Huashibaidu granule reduced the likelihood of worsening symptoms in patients with mild COVID-19. Our study supports Huashibaidu granule as an active option for early treatment of mild COVID-19 in similar well-managed medical environments. Clinical Trial Registration:www.chictr.org.cn/showproj.aspx?proj=49408, identifier: ChiCTR2000029763.

6.
Front Psychiatry ; 12: 722453, 2021.
Article in English | MEDLINE | ID: covidwho-1441150

ABSTRACT

Background: The COVID-19 pandemic drastically impacted on family life and may have caused parental distress, which in turn may result in an overreliance on less effective parenting practices. Objective: The aim of the current study was to identify risk and protective factors associated with impaired parenting during the COVID-19 lockdown. Key factors predicting maternal harsh discipline were examined in China, Italy, and the Netherlands, using a cross-validation approach, with a particular focus on the role of allomaternal support from father and grandparents as a protective factor in predicting maternal harshness. Methods: The sample consisted of 900 Dutch, 641 Italian, and 922 Chinese mothers (age M = 36.74, SD = 5.58) who completed an online questionnaire during the lockdown. Results: Although marital conflict and psychopathology were shared risk factors predicting maternal harsh parenting in each of the three countries, cross-validation identified a unique risk factor model for each country. In the Netherlands and China, but not in Italy, work-related stressors were considered risk factors. In China, support from father and grandparents for mothers with a young child were protective factors. Conclusions: Our results indicate that the constellation of factors predicting maternal harshness during COVID-19 is not identical across countries, possibly due to cultural variations in support from fathers and grandparents. This information will be valuable for the identification of at-risk families during pandemics. Our findings show that shared childrearing can buffer against risks for harsh parenting during COVID-19. Hence, adopting approaches to build a pandemic-proof community of care may help at-risk parents during future pandemics.

7.
International Journal of Environmental Research and Public Health ; 17(11), 2020.
Article in English | CAB Abstracts | ID: covidwho-1409546

ABSTRACT

The COVID-19 pandemic might lead to more mental health problems. However, few studies have examined sleep problems, depression, and posttraumatic symptoms among the general adult population during the COVID-19 outbreak, and little is known about coping behaviors. This survey was conducted online in China from February 1st to February 10th, 2020. Quota sampling was used to recruit 2993 Chinese citizens aged 18 years old. Mental health problems were assessed with the Post-Traumatic Stress Disorders (PTSD) Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the Center for Epidemiological Studies Depression inventory, and the Pittsburgh Sleep Quality Index. Exposure to COVID-19 was measured with questions about residence at outbreak, personal exposure, media exposure, and impact on livelihood. General coping style was measured by the brief Coping Style Questionnaire (SCSQ). Respondents were also asked 12 additional questions about COVID-19 specific coping behaviors. Direct exposure to COVID-19 instead of the specific location of (temporary) residence within or outside the epicenter (Wuhan) of the pandemic seems important (standardized beta: 0.05, 95% confidence interval (CI): 0.02-0.09). Less mental health problems were also associated with less intense exposure through the media (standardized beta: -0.07, 95% CI: -0.10--0.03). Perceived negative impact of the pandemic on livelihood showed a large effect size in predicting mental health problems (standardized beta: 0.15, 95% CI: 0.10-0.19). More use of cognitive and prosocial coping behaviors were associated with less mental health problems (standardized beta: -0.30, 95% CI: -0.34--0.27). Our study suggests that the mental health consequences of the lockdown impact on livelihood should not be underestimated. Building on cognitive coping behaviors reappraisal or cognitive behavioral treatments may be most promising.

8.
Front Immunol ; 12: 681516, 2021.
Article in English | MEDLINE | ID: covidwho-1399136

ABSTRACT

Coronavirus disease 2019 (COVID-19) broke out and then became a global epidemic at the end of 2019. With the increasing number of deaths, early identification of disease severity and interpretation of pathogenesis are very important. Aiming to identify biomarkers for disease severity and progression of COVID-19, 75 COVID-19 patients, 34 healthy controls and 23 patients with pandemic influenza A(H1N1) were recruited in this study. Using liquid chip technology, 48 cytokines and chemokines were examined, among which 33 were significantly elevated in COVID-19 patients compared with healthy controls. HGF and IL-1ß were strongly associated with APACHE II score in the first week after disease onset. IP-10, HGF and IL-10 were correlated positively with virus titers. Cytokines were significantly correlated with creatinine, troponin I, international normalized ratio and procalcitonin within two weeks after disease onset. Univariate analyses were carried out, and 6 cytokines including G-CSF, HGF, IL-10, IL-18, M-CSF and SCGF-ß were found to be associated with the severity of COVID-19. 11 kinds of cytokines could predict the severity of COVID-19, among which IP-10 and M-CSF were excellent predictors for disease severity. In conclusion, the levels of cytokines in COVID-19 were significantly correlated with the severity of the disease in the early stage, and serum cytokines could be used as warning indicators of the severity and progression of COVID-19. Early stratification of disease and intervention to reduce hypercytokinaemia may improve the prognosis of COVID-19 patients.


Subject(s)
COVID-19/immunology , Cytokines/genetics , Cytokines/immunology , SARS-CoV-2/immunology , Severity of Illness Index , Transcriptome/immunology , Adult , Aged , Biomarkers/blood , Chemokines/blood , Chemokines/genetics , Chemokines/immunology , Cytokines/blood , Female , Hospitalization/statistics & numerical data , Humans , Influenza, Human/blood , Influenza, Human/immunology , Male , Middle Aged
9.
Eur J Psychotraumatol ; 12(1): 1952777, 2021.
Article in English | MEDLINE | ID: covidwho-1360281

ABSTRACT

Background: People lived through different types of stresses during the COVID-19 pandemic, and stresses from different sources are believed to associate differently with mental health. Objectives: The current study aims to examine the relationship between types of stresses and mental health among the general Chinese adult population, and further explore the moderating role of social support in these relationships. Methods: This study was conducted from 1 to 10 February 2020, and 2441 participants were recruited through an online cross-sectional survey from 31 provinces in China. We used multiple linear regression analyses to examine the associations among stresses' types, social support, and mental health. Results: The study revealed that all types of stresses were associated with more mental health symptoms. Stresses from lockdown policy presented stronger associations with mental health symptoms (Beta = 0.387 for depressive symptoms and Beta = 0.385 for post-traumatic stress symptoms (PTSS)) than stresses from pandemic fear (Beta = 0.195 for depressive symptoms and Beta = 0.221 for PTSS). Moreover, greater social support enhanced the positive associations between stresses and mental health symptoms. Conclusions: Stresses from lockdown policies during the early stage of the COVID-19 epidemic are worthy of more attention. We urge more interventions are required to reduce the side-effect of lockdown policies, and also discuss implications for mental health promotion.


Antecedentes: Las personas vivieron diferentes tipos de estrés durante la pandemia de COVID-19, y se cree que el estrés de diferentes fuentes se asocia de manera diferente con la salud mental.Objetivos: El presente estudio pretende examinar la relación entre los tipos de estrés y la salud mental entre la población general adulta china, y explorar además el papel moderador del apoyo social en estas relaciones.Métodos: Este estudio se llevó a cabo del 1 al 10 de febrero de 2020, y 2441 participantes fueron reclutados a través de una encuesta transversal en línea de 31 provincias de China. Se utilizaron análisis de regresión lineal múltiple para examinar las asociaciones entre los tipos de estrés, el apoyo social y la salud mental.Resultados: El estudio reveló que todos los tipos de estrés se asociaron con más síntomas de salud mental. El estrés derivado de la política de confinamiento presentó asociaciones más fuertes con los síntomas de salud mental (Beta=0,387 para los síntomas depresivos y Beta=0,385 para los síntomas de estrés postraumático (PTSS, en siglas en inglés)) que el estrés derivado del miedo a la pandemia (Beta=0,195 para los síntomas depresivos y Beta=0,221 para los PTSS). Además, un mayor apoyo social mejoró las asociaciones positivas entre el estrés y los síntomas de salud mental.Conclusiones: El estrés provocado por las políticas de confinamiento durante la fase inicial de la epidemia de COVID-19 merece más atención. Instamos a que se realicen más intervenciones para reducir el efecto secundario de las políticas de confinamiento, y también discutimos las implicaciones para la promoción de la salud mental.背景: 新冠疫情下给人们带来各种各样的压力, 这些压力进而影响人们的精神健康状况。目的: 本研究将探究疫情多重压力与个体精神健康之间的关系, 并进一步探究社会支持是否可以缓解压力对精神健康的影响。方法: 2020å¹´2月1-10日, 通过在线调查的方式, 纳入2441名参与者。通过多元线性回归方法检验压力, 社会支持及精神健康之间的关系。结果: 研究发现, 所有的压力均显著影响精神健康结果, 隔离政策带来的压力比病毒本身带来的压力对个体精神健康的影响更大 (抑郁:Beta=0.387 VS 0.195; 创伤后应激症状:Beta=0.385 VS 0.221 for PTSS)。不合理的社会支持可能会增强压力与精神健康之间的关系。结论: 隔离政策所带来的压力对人们精神健康的副作用需要被关注, 应该采取适宜的干预措施来减少隔离对人们精神健康的副作用。.

10.
Front Psychiatry ; 12: 700493, 2021.
Article in English | MEDLINE | ID: covidwho-1348566

ABSTRACT

Background: Although several studies have shown an association of family care with a high level of depressive symptoms, the relationship between them remains indistinguishable. Objective: This study aims to examine the associations between family care, economic stress, and depressive symptoms among Chinese adults in urban and rural areas during the COVID-19 outbreak. Methods: Based on cross-sectional data collected through online surveys from February 1st to 10th 2020 in China the present study recruited 2,858 adults. It used multiple linear regression to examine the association between family care and depressive symptoms, while economic stress was examined as moderators on the above relationship. Results: The results showed that caring for both the elderly and children was significantly associated with higher depressive symptoms compared with non-caregivers (B = 2.584, 95%CI: 1.254, 3.915), and a similar result was also found in urban areas. Also, caring for the elderly only was also had a higher level of depressive symptoms than non-caregivers in rural areas (B = 3.135, 95%CI: 0.745, 5.525). Meeting the care needs was significantly associated with lower depressive symptoms compared with unmet care needs, while for rural caregivers, the results were not significant. Besides, economic stress strengthened the effect of family care needs on depressive symptoms for sandwich-generation caregivers who provide care to both the elderly and children (B = 0.605, 95%CI: 0.077, 1.134). While in rural areas, the moderation effects of economic stress were only found for elderly caregivers (B = 1.106, 95%CI: 0.178, 2.035). Conclusion: These findings suggest that we should pay more attention to the family caregiver's mental health during the COVID-19 outbreak. In addition, more effective policies should be developed to provide financial support for family caregivers, especially for sandwich-generation caregivers and rural elderly caregivers.

11.
Nat Sci Sleep ; 13: 1307-1318, 2021.
Article in English | MEDLINE | ID: covidwho-1337600

ABSTRACT

Introduction: Bedtime procrastination (BP) has a close relationship with one's chronotype, from a biological perspective on time. However, it remains unknown whether there is an association between BP and psychological time. Therefore, the aim of the present study was to evaluate the relationship between time perspective (TP) and BP and the effect of TP on the relationship between BP and chronotype by examining a sample of college students pre- and post-COVID-19 outbreak. Methods: A total of 628 Chinese students (267 in pre-outbreak and 361 in post-outbreak) validly completed the Chinese version of the Bedtime Procrastination Scale, the Zimbardo Time Perspective Inventory (ZTPI), and the Morningness-Eveningness Questionnaire. Results: Students with more BP behaviors exhibited greater deviation from a balanced TP, especially after the COVID-19 outbreak. Hierarchical regression analyses revealed that the past-negative and future orientations, as operationalized by the ZTPI, contributed independently to BP behaviors. The structural equation modeling analyses further demonstrated that morningness was significantly related to a more future-oriented TP, which in turn decreased BP in pre- and post-COVID-19 outbreak samples, while morningness was associated with a less past-negative-oriented TP, which in turn decreased BP only in the post-COVID-19 outbreak sample. Conclusion: This study indicated that TP in students with BP predominantly focused on future orientation and that TP can mediate the relationship between chronotype and BP behaviors. However, the COVID-19 pandemic may disrupt the time flow and change the role of chronotype-TP in BP. These findings explain how individual differences in TP are associated with BP, which may be helpful in designing effective interventions to avoid BP, from the viewpoint of time perspective therapy.

12.
Phytomedicine ; 91: 153671, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1313371

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of Hua Shi Bai Du Granule (Q-14) plus standard care compared with standard care alone in adults with coronavirus disease (COVID-19). STUDY DESIGN: A single-center, open-label, randomized controlled trial. SETTING: Wuhan Jinyintan Hospital, Wuhan, China, February 27 to March 27, 2020. PARTICIPANTS: A total of 204 patients with laboratory-confirmed COVID-19 were randomized into the treatment group and control group, consisting of 102 patients in each group. INTERVENTIONS: In the treatment group, Q-14 was administered at 10 g (granules) twice daily for 14 days, plus standard care. In the control group, patients were provided standard care alone for 14 days. MAIN OUTCOME MEASURE: The primary outcome was the conversion time for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral assay. Adverse events were analyzed in the safety population. RESULTS: Among the 204 patients, 195 were analyzed according to the intention-to-treat principle. A total of 149 patients (71 vs. 78 in the treatment and control groups, respectively) tested negative via the SARS-CoV-2 viral assay. There was no statistical significance in the conversion time between the treatment group and control group (Full analysis set: Median [interquartile range]: 10.00 [9.00-11.00] vs. 10.00 [9.00-11.00]; Mean rank: 67.92 vs. 81.44; P = 0.051). The recovery time for fever was shorter in the treatment group than in the control group. The disappearance rate of symptoms like cough, fatigue, and chest discomfort was significantly higher in the treatment group. In chest computed tomography (CT) examinations, the overall evaluation of chest CT examination after treatment compared with baseline showed that more patients improved in the treatment group. There were no significant differences in the other outcomes. CONCLUSION: The combination of Q-14 and standard care for COVID-19 was useful for the improvement of symptoms (such as fever, cough, fatigue, and chest discomfort), but did not result in a significantly higher probability of negative conversion in the SARS-CoV-2 viral assay. No serious adverse events were observed. TRIAL REGISTRATION: ChiCTR2000030288.


Subject(s)
COVID-19 , Drugs, Chinese Herbal/therapeutic use , COVID-19/therapy , China , Female , Humans , Male , Middle Aged , Treatment Outcome
13.
JMIR Pediatr Parent ; 4(3): e27974, 2021 Jul 13.
Article in English | MEDLINE | ID: covidwho-1311342

ABSTRACT

We examined internet searches indicative of abusive parental behaviors before and after the World Health Organization's declaration of COVID-19 as a pandemic (March 11, 2020) and subsequent lockdown measures in many countries worldwide. Using Google Trends, we inferred search trends between December 28, 2018, and December 27, 2020, for queries consisting of "mother," "father," or "parents" combined with each of the 11 maltreatment-related verbs used in the Conflict Tactics Scales, Parent-Child version. Raw search counts from the Google Trends data were estimated using Comscore. Of all 33 search terms, 28 terms showed increases in counts after the lockdowns began. These findings indicate a strong increase in internet searches relating to occurrence, causes, or consequences of emotional and physical maltreatment since the lockdowns began and call for the use of maltreatment-related queries to direct parents or children to online information and support.

14.
EClinicalMedicine ; 38: 101010, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1300745

ABSTRACT

Background: We aimed to assess the safety and immunogenicity of an inactivated vaccine against COVID-19 in Chinese adults aged ≥18 years. Methods: This is an ongoing randomized, double-blind, placebo-controlled, phase 1/2 clinical trial among healthy adults aged ≥18 years in Henan Province, China. Participants (n = 336 in 18-59 age group and n = 336 in ≥60 age group) were enrolled between April 12 and May 17 2020, and were equally randomized to receive vaccine or placebo (aluminum hydroxide adjuvant) in a three-dose schedule of 2·5, 5, or 10 µg on days 0, 28, and 56. Another 448 adults aged 18-59 years were equally allocated to four groups (a one-dose schedule of 10 µg, and two-dose schedules of 5 µg on days 0 and 14/21/28) and received vaccine or placebo (ratio 3:1 within each group). The primary outcomes were 7-day post-injection adverse reactions and neutralizing antibody titres on days 28 and 90 after the whole-course vaccination. Trial registration: www.chictr.org.cn #ChiCTR2000031809. Findings: The 7-day adverse reactions occurred in 4·8% to 32·1% of the participants in various groups, and most adverse reactions were mild, transient, and self-limiting. Twenty participants reported 68 serious adverse events which were judged to be unrelated to the vaccine. The 90-day post-injection geometric mean titres of neutralizing antibody ranged between 87 (95% CI: 61-125) and 129 (99-169) for three-dose schedule among younger and older adults; 20 (14-27), 53 (38-75), and 44 (32-61) in 5 µg days 0 and 14/21/28 groups, respectively, and 7 (6-9) in one-dose 10 µg group. There were no detectable antibody responses in all placebo groups. Interpretation: The inactivated vaccine against COVID-19 was well tolerated and immunogenic in both younger and older adults. The two-dose schedule of 5 µg on days 0 and 21/28 and three-dose schedules on days 0, 28, and 56 could be further evaluated for long-term safety and efficacy in the phase 3 trials.

15.
J Health Psychol ; : 13591053211025596, 2021 Jun 27.
Article in English | MEDLINE | ID: covidwho-1285167

ABSTRACT

The COVID-19 pandemic is associated with Posttraumatic Stress Symptoms (PTSS) and self-reported Posttraumatic Growth (PTG) in the general population. This study used linear regressions for analyses, based on an online survey conducted during the COVID-19 lockdown among 2441 Chinese adults in February 2020. The results showed negative coping and attributing responsibilities to individuals were associated with more PTSS, while both positive and negative coping, as well as attributing responsibilities to individuals were related to more PTG. Moreover, attribution of responsibilities modified the association between coping and PTSS, but not PTG. These findings shed light on mental health interventions in a pandemic context.

16.
Engineering (Beijing) ; 2021 Jun 12.
Article in English | MEDLINE | ID: covidwho-1267670

ABSTRACT

Understanding the immunological characteristics of monocytes-including the characteristics associated with fibrosis-in severe coronavirus disease 2019 (COVID-19) is crucial for understanding the pathogenic mechanism of the disease and preventing disease severity. In this study, we performed single-cell transcriptomic sequencing of peripheral blood samples collected from six healthy controls and 14 COVID-19 samples including severe, moderate, and convalescent samples from three severely/critically ill and four moderately ill patients. We found that the monocytes were strongly remodeled in the severely/critically ill patients with COVID-19, with an increased proportion of monocytes and seriously reduced diversity. In addition, we discovered two novel severe-disease-specific monocyte subsets: Mono 0 and Mono 5. These subsets expressed amphiregulin (AREG), epiregulin (EREG), and cytokine interleukin-18 (IL-18) gene, exhibited an enriched erythroblastic leukemia viral oncogene homolog (ErbB) signaling pathway, and appeared to exhibit pro-fibrogenic and pro-inflammation characteristics. We also found metabolic changes in Mono 0 and Mono 5, including increased glycolysis/gluconeogenesis and an increased hypoxia inducible factor-1 (HIF-1) signaling pathway. Notably, one pre-severe sample displayed a monocyte atlas similar to that of the severe/critical samples. In conclusion, our study discovered two novel severe-disease-specific monocyte subsets as potential predictors and therapeutic targets for severe COVID-19. Overall, this study provides potential predictors for severe disease and therapeutic targets for COVID-19 and thus provides a resource for further studies on COVID-19.

17.
J Biomed Sci ; 28(1): 43, 2021 Jun 07.
Article in English | MEDLINE | ID: covidwho-1261273

ABSTRACT

BACKGROUND: Coronavirus disease 19 (COVID-19) first appeared in the city of Wuhan, in the Hubei province of China. Since its emergence, the COVID-19-causing virus, SARS-CoV-2, has been rapidly transmitted around the globe, overwhelming the medical care systems in many countries and leading to more than 3.3 million deaths. Identification of immunological epitopes on the virus would be highly useful for the development of diagnostic tools and vaccines that will be critical to limiting further spread of COVID-19. METHODS: To find disease-specific B-cell epitopes that correspond to or mimic natural epitopes, we used phage display technology to determine the targets of specific antibodies present in the sera of immune-responsive COVID-19 patients. Enzyme-linked immunosorbent assays were further applied to assess competitive antibody binding and serological detection. VaxiJen, BepiPred-2.0 and DiscoTope 2.0 were utilized for B-cell epitope prediction. PyMOL was used for protein structural analysis. RESULTS: 36 enriched peptides were identified by biopanning with antibodies from two COVID-19 patients; the peptides 4 motifs with consensus residues corresponding to two potential B-cell epitopes on SARS-CoV-2 viral proteins. The putative epitopes and hit peptides were then synthesized for validation by competitive antibody binding and serological detection. CONCLUSIONS: The identified B-cell epitopes on SARS-CoV-2 may aid investigations into COVID-19 pathogenesis and facilitate the development of epitope-based serological diagnostics and vaccines.


Subject(s)
COVID-19 , Epitopes, B-Lymphocyte , Peptide Library , SARS-CoV-2 , Viral Proteins , COVID-19/genetics , COVID-19/immunology , Epitopes, B-Lymphocyte/genetics , Epitopes, B-Lymphocyte/immunology , Humans , SARS-CoV-2/genetics , SARS-CoV-2/immunology , Viral Proteins/genetics , Viral Proteins/immunology
18.
Risk Manag Healthc Policy ; 14: 1843-1853, 2021.
Article in English | MEDLINE | ID: covidwho-1231287

ABSTRACT

Background: The Coronavirus Diseases (COVID-19) pandemic is a global public health challenge and provides an opportunity to investigate the unclear relationship between risk perception, social support, and mental health. This study aims to examine the association between risk perception and mental health while taking social support as a moderator. Methods: An online cross-sectional study recruiting 2993 participants was conducted in China, from 1st to 10th, February 2020. The relationship between risk perception, social support, and mental health was examined using multivariate linear regression analyses. Results: This study indicated that risk perception was associated with a higher level of mental health symptoms. The subscale "Perceived uncontrollability" seemed to present a stronger correlation with depressive symptoms (Beta=0.306) and post-traumatic stress disorder (PTSD) symptoms (Beta=0.318) than the subscale "Perceived Severity" did. Moreover, social support moderated the relationship between perceived uncontrollability and mental health symptoms. Conclusion: In the context of the COVID-19 pandemic, it is necessary to design mental health strategies and programs from a risk perception perspective (more mental health strategies should be delivered to build reasonable risk perception), while social support from family and friends may be protective to against depressive symptoms and PTSD symptoms. There is a demand for mental health intervention from a risk perception perspective.

19.
Front Psychiatry ; 12: 654548, 2021.
Article in English | MEDLINE | ID: covidwho-1221984

ABSTRACT

Objectives: The objectives of this study are to assess the relationship between media exposure and post-traumatic stress symptoms (PTSS) and to highlight the underlying mechanisms mediated by risk perception. Methods: This survey was conducted online in China from February 1st to February 10th, 2020. A total of 2,858 Chinese citizens aged ≥18 years from 31 provinces and autonomous regions were recruited to participate in a cross-sectional study. Self-report questionnaires were used to assess media exposure, PTSS, and risk perception. Results: The prevalence of respondents with heightened PTSS scores was 22.2%. After controlling for covariates, media exposure (more than five times a day) was significantly and positively associated with a high level of PTSS (B = 4.11, p < 0.001), and risk perception (worry and severity) significantly mediated the relationship between media exposure and PTSS (all 95% CIs did not include 0). Conclusions: Based on these findings, the frequency of media exposure was associated with PTSS. Risk perception (worry and severity) mediated the relationship between media exposure and PTSS. The mental health, particularly PTSS, of the general population should be closely monitored and "infodemics" should be combatted while addressing the COVID-19 outbreak; cognitive interventions may be promising.

20.
Int J Infect Dis ; 107: 5-11, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1220862

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the respiratory and physical function of patients who retested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA during post-coronavirus disease 2019 (COVID-19) rehabilitation. METHODS: A total of 302 discharged COVID-19 patients were included. Discharged patients were followed up for 14 days to 6 months. The modified Medical Research Council (mMRC) dyspnea scale, Borg rating of perceived exertion, and manual muscle testing (MMT) scores on day 14 and at 6 months after discharge were compared between the redetectable positive (RP) and non-RP (NRP) groups. Prognoses of respiratory and physical function were compared between patients who recovered from moderate and severe COVID-19. RESULTS: Of the study patients, 7.6% were RP. The proportion of patients who used antiviral drugs was significantly lower in the RP group than in the NRP group. There were no differences in mMRC, Borg, or MMT scores within the RP and NRP groups. The mMRC, Borg, and MMT scores were worse for patients with severe disease when compared to those with moderate disease at both follow-up time points. CONCLUSIONS: COVID-19 patients who did not take antiviral drugs were more likely to be RP after discharge. The recovery of respiratory and physical function was not related to re-positivity during rehabilitation, but was related to disease severity during hospitalization.


Subject(s)
COVID-19 Nucleic Acid Testing , COVID-19/physiopathology , Muscle Strength/physiology , Respiration , SARS-CoV-2 , Adolescent , Adult , Aged , COVID-19/virology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Patient Discharge , Severity of Illness Index , Young Adult
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